Senior Network Contracting Manager, Health Systems

CVS Health; Louisiana; Híbrido; USD 54.000 - 159.000; Jornada completa

Descripción de la vacante

CVS Health seeks an experienced Contract Negotiations professional to manage contract development, review and settlements with providers, ensuring accessibility, quality and cost goals.

You will build relationships with physicians and network teams, lead negotiation programs, forecast industry changes, and coach junior colleagues while supporting cross-functional pricing and reimbursement modeling. This is a full-time position.

Formación

• 5+ years in provider contracting, claims management, or patient management.
• 5+ years in claims environment.
• 5+ years with ACAS and HRP claim platforms, products, and benefits.

Responsabilidades

• Develop, maintain, and enhance relationships with physicians/providers and local network and patient management teams in the markets with Aetna.
• Establish programs for the organization to advance Contract Negotiations initiatives.
• Forecast changes within the Contract Negotiations industry and develop modification strategies with process improvement methods.
• Collaborate cross-functionally to support provider compensation and pricing development for negotiations and reimbursement modeling.
• Determine recommendations to manage cost issues and support cost-saving settlement initiatives.
• Assist in network development and management strategies to support cross-market units.
• Coach junior colleagues in techniques and responsibilities.
• Perform other duties as assigned by manager.

Conocimientos

Provider contracting

Claims management

Patient management

Educación

Bachelor's degree

Herramientas

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Descripción del empleo

CVS Health seeks an experienced Contract Negotiations professional to manage contract development, review and settlements with providers, ensuring accessibility, quality and cost goals.

You will build relationships with physicians and network teams, lead negotiation programs, forecast industry changes, and coach junior colleagues while supporting cross-functional pricing and reimbursement modeling. This is a full-time position.